대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 1169 Date 2020-03-17

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  • Courtesy of Cherry Kim, Ki Yeol Lee / Korea university Ansan hospital
  • Age/Sex 44 / M
  • Chief Complaintmild dysphagia
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Esophageal leiomyoma
Radiologic Findings
Fig 1. Chest PA shows bulging contour mass like lesion at the mediastinum.
Fig 2-4. About 8 cm extent segmental encircling mass with amorphus calcification in the mid-esophagus is noted on CT scans.
Brief Review
Most common benign tumor of the esophagus
- Smooth muscle neoplasm
- 8-43 per 10,000 autopsy series
Location : typically involve the mid to distal esophagus
- Lower (60%), mid (30%), upper (10%)
Epidemiology
- Young and middle age groups (20-50 years)
- Gender M:F = 2:1
Clinical presentation
- Usually asymptomatic
- Large tumor : dysphagia, regurgitation, obstruction, chest pain
- <5cm, asymptomatic : no need treatment

Chest radiography
- Obliteration of azygoesophageal recess

Fluoroscopy
- Round/Ovoid mass, well-outlined by barium
- Smooth surface
- Obtuse angle with esophageal wall

CT
- Homogeneous soft tissue attenuated mass
- Presence of calcification is pathognomonic
- No signs of invasion to adjacent
- Mild to moderate diffuse enhancement

MRI
- T1: Iso to high, T2: higher intensity than T1
Please refer to
Case 61, Case 303, Case 528, Case 642, Case 661,
References
1) Yang PS, Lee KS, Lee SJ et-al. Esophageal leiomyoma: radiologic findings in 12 patients. Korean J Radiol. 2002;2 (3): 132-7.
2) Jiang W, Rice TW, Goldblum JR. Esophageal leiomyoma: experience from a ingle institution. Dis. Esophagus. 2013;26 (2): 167-74. doi:10.1111/j.1442-2050.2012.01345.
Keywords
esophagus, esophageal leiomyoma,

No. of Applicants : 82

▶ Correct Answer : 48/82,  58.5%
  • - Asan Medical Center , Korea (South) WOOIL KIM
  • - Seoul Veterans Hospital , Korea (South) JI HOON NOH
  • - Seoul National University Hospital , Korea (South) JI HEE KANG
  • - , Korea (South) JIN YOUNG LEE
  • - Chonnam National University Hwasun Hospital , Korea (South) WONGI JEONG
  • - Korea University Ansan Hospital , Korea (South) MOIN HA
  • - Kitano Hospital , Japan SATOSHI IKEDA
  • - Hamamatsu University Hospital , Japan HAYATO NOZAWA
  • - Narayana Multispeciality Hospital Jaipur Rajasthan , India JAINENDRA JAIN
  • - National Center for Global Health and Medicine , Japan HIROSHI TAKUMIDA
  • - Cabinet Capricorne, clinique sainte-clotilde , Reunion FABIEN HO
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey MERIC TUZUN
  • - The University of Tokyo Hospital , Japan RYO KUROKAWA
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia YURANGA WEERAKKODY
  • - Mayo Clinic , United States AKITOSHI INOUE
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Fortis hospital , Mohali , India SHALEEN RANA
  • - Kyeongpook National University Hospital , Korea (South) PARK BYUNG GEON
  • - , Korea (South) CHOHEE KIM
  • - , Korea (South) PARK JONGMIN
  • - Inje University Pusan Paik Hospital , Korea (South) DA SOM KIM
  • - Seoul Veterans Hospital , Korea (South) JANG SEONG WON
  • - Vikram Hospital , India SANJEEV J MUDAKAVI
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Lille , France BENOIST CAPON
  • - , Korea (South) DAJUNG KIM
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Chonnam National University Hwasun Hospital , Korea (South) PARK HYE MI
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Chonnam National University Hwasun Hospital , Korea (South) INWOO CHOI
  • - CH de la Cote Basque , France PAUL ARDILOUZE
  • - Asan Medical Center , Korea (South) EUNJI CHOI
  • - Chungbuk National University Hospital , Korea (South) YEONGTAE PARK
  • - TB centre kasaragod. , India rikhy krishnan
  • - Ondokuz Mayis University , Turkey CETIN CELENK
  • - Scans world , India PHILSON JOSEPH MUKKADA
  • - , India SUSHANT JOSHI
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - Private sector , Greece VASILIOS TZILAS
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Showa University Fujigaoka Hospital , Japan KYOKO NAGAI
  • - Asan Medical Center , Korea (South) HYEMIN AHN
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - IRSA LA ROCHELLE , France JEAN LUC BIGOT
  • - , Taiwan NING CHIEN
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
▶ Correct Answer as Differential Diagnosis : 17/82,  20.7%
  • - Chungbuk National University Hospital , Korea (South) JUNGHWAN KIM
  • - Other , Korea (South) SANG HYUP HONG
  • - Yeungnam University Medical Center , Korea (South) JONGSOO PARK
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Beaulieu clinic Geneva , Switzerland GILLES GENIN
  • - , Korea (South) HYUNGYU LEE
  • - VENKATESHWAR HOSPITAL NEW DELHI , India RAKESH BHATIA
  • - Asan Medical Center , Korea (South) YURA AHN
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Hallym University Dongtan Medical Center , Korea (South) MINSU KIM
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Jordan HISHAM IBRAHIM KHATIB
  • - Ajou University Hospital , Korea (South) HYERIN KIM
  • - , Japan KAZUMA TERAUCHI
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
▶ Semi-Correct Answer : 1/82,  1.2%
  • - , China FANG YING GEN
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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